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Blood Pressure Positions
No, this isn't a dirty post ;-)
Just a quick question. So I have an old school blood pressure device, complete with the stethoscope and gauge. I don't really trust the electronic ones because the readings can be all over the place and sometimes just seeing a bad reading--whether it's real or not--is enough to bring my BP to that reading.
So my question is, why do I get so many different readings when sitting in different places? When I normally take my blood pressure, I'm sitting in a computer chair at my desk with my leg arm resting against it. The bend of my arm is on the same level as my heart so I assume that is correct. The readings I get from this position are usually accurate and within normal ranges--well, normal for me at least (130/80 on average).
But when I sit down on the couch and take my blood pressure and I feel like I'm the same position as with the desk but a little more comfortable, the readings are at least 10 points higher for both numbers; doing it this way, it wouldn't be abnormal to see 150/90.
I get that there's this hydrostatic pressure where if your arm is higher, your BP will be lower, and vice versa. But I'm just worried that my numbers might actually be higher than they really are. Every now and again I get a doctor who takes it and it's elevated, but the other half of the time it's actually more normal than at home.
Is it safe to assume that if my blood pressure readings sitting at my desk are the same as my blood pressure readings lying down are either the same or close enough, then that's probably the right number?
Just a quick question. So I have an old school blood pressure device, complete with the stethoscope and gauge. I don't really trust the electronic ones because the readings can be all over the place and sometimes just seeing a bad reading--whether it's real or not--is enough to bring my BP to that reading.
So my question is, why do I get so many different readings when sitting in different places? When I normally take my blood pressure, I'm sitting in a computer chair at my desk with my leg arm resting against it. The bend of my arm is on the same level as my heart so I assume that is correct. The readings I get from this position are usually accurate and within normal ranges--well, normal for me at least (130/80 on average).
But when I sit down on the couch and take my blood pressure and I feel like I'm the same position as with the desk but a little more comfortable, the readings are at least 10 points higher for both numbers; doing it this way, it wouldn't be abnormal to see 150/90.
I get that there's this hydrostatic pressure where if your arm is higher, your BP will be lower, and vice versa. But I'm just worried that my numbers might actually be higher than they really are. Every now and again I get a doctor who takes it and it's elevated, but the other half of the time it's actually more normal than at home.
Is it safe to assume that if my blood pressure readings sitting at my desk are the same as my blood pressure readings lying down are either the same or close enough, then that's probably the right number?
Best Answer
Consumer Report ercently evaluated a bunch of electronic blood pressure monitors - maybe 6 months ago. They wouldn't even call them acceptable if the accuracy varied by more than 1%. Although, it is entirely possible that they donn't find the pulse at all. That happens to me some times on start up. I've set the high pressure to 140mm, but it will occasionally ignore that and pump to 170mm even though the end result falls in the same margins as before.
The only one that seemed to work was the one hooked into the monitor above my bed and on a timer. All the mobile ones which the nurses used were useless. The only conclusion I can come up with is that the artery in my arm is deeper than usual? It's definitely there, the GP finds it with the scope.
It has shocked me a few times in rehab and hospital when the cuff blows up so much that it hurts, and the pressure forces the hose to pop off the cuff.
Okay, I give. What ed34 is reporting is absolutely a huge difference. That would not be acceptable to me, either. I just haven't ever experienced anything like that and am doing fine with my electronic wrist cuff.
I have never had accurate results from electronic blood pressure monitors. Each time one is used on me it says 180/100 and yet when my GP uses the stethascope and mercury, it shows 120/70 and that's a HUGE difference. Many times the electronic machines simply keep blowing up the cuff until my arm turns blue, as though they can't find a pulse. It is correct to say that blood pressure is not static, it is highly dynamic and alters all the time. Even changing your thoughts can increase or decrease it. Shuffling in a chair will make it change as will just moving an arm.
The one with the mercury bar on the wall is absolutely the most accurate. I don't think those ever have to be recalibrated. Millimeters of mercury is millimeters of mercury. The ones with the dial gauge get inaccurate over time, but it's not cost-effective to recalibrate them. You just throw them out when you become aware that they've lost their accuracy.
I actually have not seen one of the mercury sphygmomanometers in a long, long, time, so that's where I was coming from. The electronic ones, you're right, are probably not as accurate as the ones that have a mercury column. But neither are the ones that have the stethoscope and the needle gauge. Both of the consumer types -- the ones with the stethoscope and the electronic ones -- are accurate enough to show you trends, as they do tend to measure the same pressure the same way every time. So if you use a consistent body position, they can show you trends -- upward trend, downward trend, time of day trend, and home vs. doctor's office.
When you do an internet search for sphygmomanometer accuracy, what you really get is people's opinions. In all fairness, that's also all that you're getting here. So why not do your own empirical testing. Take your own cuff to the doctor's office, wait ten minutes or so after you have been measured with the mercury sphygmomanometer, and take your blood pressure in the same arm with your own cuff. As long as you haven't gotten up and moved around, it should be close to the same reading. If you get rushed out of the exam room, you could just take a seat in the waiting room for ten minutes or so, and then do it there. Repeat several times, and log the results.
If your own cuff is consistently measuring higher or lower than the doctor's cuff, it's no big deal -- as long as the difference is a consistent one, and as long as you know about it. Again, what you are interested in is trends, so even if there is a consistent difference between your cuff and the doctor's, you can still track any trends, as long as the difference is consistent. And try to sit in the same body position every time, because for you, that does seem to make a difference. You want to compare apples to apples, so to speak.
If your "normal" pressure is 130/80, and you fairly often get readings as high as 150/90, you should consider treatment. That's not so high that you couldn't try something like the DASH diet, or some other nonpharmaceutical method, before you had to get on medication. Good luck.
I actually have not seen one of the mercury sphygmomanometers in a long, long, time, so that's where I was coming from. The electronic ones, you're right, are probably not as accurate as the ones that have a mercury column. But neither are the ones that have the stethoscope and the needle gauge. Both of the consumer types -- the ones with the stethoscope and the electronic ones -- are accurate enough to show you trends, as they do tend to measure the same pressure the same way every time. So if you use a consistent body position, they can show you trends -- upward trend, downward trend, time of day trend, and home vs. doctor's office.
When you do an internet search for sphygmomanometer accuracy, what you really get is people's opinions. In all fairness, that's also all that you're getting here. So why not do your own empirical testing. Take your own cuff to the doctor's office, wait ten minutes or so after you have been measured with the mercury sphygmomanometer, and take your blood pressure in the same arm with your own cuff. As long as you haven't gotten up and moved around, it should be close to the same reading. If you get rushed out of the exam room, you could just take a seat in the waiting room for ten minutes or so, and then do it there. Repeat several times, and log the results.
If your own cuff is consistently measuring higher or lower than the doctor's cuff, it's no big deal -- as long as the difference is a consistent one, and as long as you know about it. Again, what you are interested in is trends, so even if there is a consistent difference between your cuff and the doctor's, you can still track any trends, as long as the difference is consistent. And try to sit in the same body position every time, because for you, that does seem to make a difference. You want to compare apples to apples, so to speak.
If your "normal" pressure is 130/80, and you fairly often get readings as high as 150/90, you should consider treatment. That's not so high that you couldn't try something like the DASH diet, or some other nonpharmaceutical method, before you had to get on medication. Good luck.
It's funny that both you and flycaster have mentioned electronic cuffs are more accurate than the non-electronic versions because it seems that every time I do a search on electronic blood pressure cuffs and their accuracy, I receive similar results. For the electronic blood pressure cuff on the bicep, those tend to give a higher systolic rating sometimes while the wrist cuffs tend to be the least accurate out of all of the cuffs.
I have had a nurse practitioner use one of the wrist cuffs on me but I've never had a doctor's office use an electronic bicep cuff--it's always been that mercury bar on the wall with the stethoscope.
I guess I'll just assume that whatever position I'm in and whatever device I use to measure my BP, so long as my arm is level with my heart, that it should be showing me accurate numbers.
I have had a nurse practitioner use one of the wrist cuffs on me but I've never had a doctor's office use an electronic bicep cuff--it's always been that mercury bar on the wall with the stethoscope.
I guess I'll just assume that whatever position I'm in and whatever device I use to measure my BP, so long as my arm is level with my heart, that it should be showing me accurate numbers.
I agree with Flycaster. I think that in the early days of the electronic bp cuffs, they may have been less reliable, but now they are fine. If you'll notice, almost all hospitals and doctors use an electronic cuff now. And when you say you have an "old school" cuff, unless you have one that has an actual column of mercury to show you the reading, the one you have is going to tend to get less reliable with age. The more common manual ones with just a dial need to be thrown out, eventually.
Concerning the fact that you're getting different readings in different positions, I don't know if you're ever going to be able to explain that. Lying down can show lower blood pressure than sitting up, but otherwise, I don't know about that. What I would do is to pick one position and stick with it, so that you can compare readings over time. That way, you can at least tell if your blood pressure is showing a trend up or down, or remaining stable.
You might want to keep a log of your results, and do note the time of day for each reading, because bp varies naturally with the time of day. Some of your variations could be due to time of day. If you keep everything else constant, except for the time of day, that will allow you to isolate that as a variable. Also note the site, whether it was home or the doctor's office. That way, you can see for sure if there is a trend for the site.
Personally, I use an electronic wrist cuff, because it is the absolute easiest to take on and off. The one I have is a cheap brand, but the readings it gives me do correspond pretty closely to what my doctors' cuffs show, or at least closely enough. Really, what you're looking for is an average. If your average reading is above normal, then you need to think about doing something about it. If it's only high at the doctor's office, then it probably is high in other situations of mild stress, and you still need to think about doing something about it. Good luck.
Concerning the fact that you're getting different readings in different positions, I don't know if you're ever going to be able to explain that. Lying down can show lower blood pressure than sitting up, but otherwise, I don't know about that. What I would do is to pick one position and stick with it, so that you can compare readings over time. That way, you can at least tell if your blood pressure is showing a trend up or down, or remaining stable.
You might want to keep a log of your results, and do note the time of day for each reading, because bp varies naturally with the time of day. Some of your variations could be due to time of day. If you keep everything else constant, except for the time of day, that will allow you to isolate that as a variable. Also note the site, whether it was home or the doctor's office. That way, you can see for sure if there is a trend for the site.
Personally, I use an electronic wrist cuff, because it is the absolute easiest to take on and off. The one I have is a cheap brand, but the readings it gives me do correspond pretty closely to what my doctors' cuffs show, or at least closely enough. Really, what you're looking for is an average. If your average reading is above normal, then you need to think about doing something about it. If it's only high at the doctor's office, then it probably is high in other situations of mild stress, and you still need to think about doing something about it. Good luck.
I started taking my blood pressure with a stethoscope and gauge about 15 years ago, using a doctor's cuff who passed away and it ended up with me. I found it almost impossible to use by myself with any accuracy. Any movement of your arm during the test can change the results, in my opinion.
The electronic units are much easier to use, and in my opinion more accurate if doing it yourself. My hospital uses electronic devices and they have detected a number of problems as well as found my condition normal. I'd simply proceed with confidence with an electronic unit as long as it is highly rated.
The electronic units are much easier to use, and in my opinion more accurate if doing it yourself. My hospital uses electronic devices and they have detected a number of problems as well as found my condition normal. I'd simply proceed with confidence with an electronic unit as long as it is highly rated.
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